Production of critical cytokines by T-cells and other host cells mediates resistance and susceptibility to infectious agents. While these cytokines are of primary importance in host defense, there may also be metabolic consequences of their production. Thus, over-production of the cytokine TNFa in the case of malignant or chronic inflammatory disease such as TB or AIDS may result in wasting. We are testing two doses of the drug thalidomide in a placebo-controlled clinical trial in patients with HIV associated wasting. We hope to reduce the production of TNFa and thereby reduce wasting in these patients. We also plan to evaluate the effect of thalidomide on HIV replication. The study is on-going and remains blinded. We plan to continue enrolling patients into the study until the statistically relevant number is attained. At that point, the study will be unblinded, and formal evaluation of the data can take place.